Study Illustrates Impact of Opioid Use on Workers’ Comp Claim Costs in Michigan

August 29, 2012

The use of long-acting opioid medications for treatment of chronic pain is a significant driver of medical indemnity expenses in workers’ compensation claims, reports a study entitled, “The Effects of Opioid Use on Workers’ Compensation Claim Cost in the State of Michigan,” in the August 2012 issue of The Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).

Jeffrey Austin White, MS, director of Medical Management Practices & Strategy for Accident Fund Holdings, Inc., along with Edward Bernacki, MD, MPH; Xuguang Tao, MD, PhD; Milan Talreja, MA, PMP and Jack Tower, MS, Data Analytics and Medical Trends specialist for Accident Fund Holdings evaluated four years’ worth of workers’ compensation claims in the State of Michigan to determine the effect of opioid prescriptions on workers’ compensation claims.

The recent shift in prescribing patterns to more patients consuming opioid medications is more prevalent today than ever before.

Opioid medications are now being prescribed at higher dosages in pure form and are routinely making their way into the hands of injured workers without the proper controls, regardless of health risks.

Escalating problems such as overdose, addiction, and even death have reached epidemic proportions, according to the Centers for Disease Control (CDC), and are now commonly reported in association with workers’ compensation claims with 55-85 percent of injured workers across the country receiving narcotics for chronic pain relief.

“To our knowledge, this is the first scientifically validated study to demonstrate that long-acting opioids, even if taken just once, leads to catastrophic claim cost,” Tower said. “It is unique in that we look at the effect of short-acting and long-acting opioids separately.”

Accident Fund Holdings has been monitoring the use of opioids to manage chronic pain for years and the results of this study have validated the company’s efforts to increase medical management on these claims.

“Ultimately, our research indicates the need to monitor or intervene on claims treated with long-acting opioids for nonmalignant chronic pain,” Patrick Walsh, vice president and chief claims officer for Accident Fund Holdings, said. “Our goal is to protect our injured workers from addiction or not being able to return to work.”

The narcotics program has been in production for over a year at Accident Fund Insurance Company of America, a subsidiary of Accident Fund Holdings, and has been expanded to United Heartland with Third Coast Underwriters and CompWest to follow. The primary components of the program include early detection software, activity driven workflows and peer-to-peer intervention strategies.

Source: Accident Fund Holdings, Inc.

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